Column: Readers respond to question 'what would you do if you were Bronson's CEO?'

Al Jones | Kalamazoo opinionPeople seem to know what they’d do if they were a CEO.

Ten readers offered thoughts this week on the situation of a 49-year-old Kalamazoo man, who said he has asked Bronson Methodist Hospital for financial assistance to offset a $2,070 bill that resulted from a Feb. 20 emergency room visit.

Stephen Scott said he has a part-time job (eight hours a week) and is getting some help from the state ($225 per month from Michigan’s Family Independence Agency for food) as he hunts for full-time work.

But he said in a recent letter to Frank Sardone, president and chief executive officer of Bronson Healthcare Group Inc., “As of Monday 4/05/10, I am being told that I do not make enough money to qualify. This is the most absurd thing I think I have ever heard. …”

Hospital spokeswoman Susan Watts said the hospital is still working with Mr. Scott and has not gone through all the appropriate, standard procedures to determine what help he may receive to manage his bill.

With the idea that CEOs often have to make tough decisions, and those decisions are often criticized, we asked if you were the CEO, what would you do?

Here are some responses:

• “Apply an insurance deductible to this bill,” wrote Hank Renzema of Kalamazoo. “The hospital rarely collects more than 45 percent from an insurance company. Now we are down to 1K ($1,000 of Scot’s $2,070 bill). Total all the person’s monthly income and collect 10 percent per month for a year. Write the rest off. The hospital gets close to what it would collect from an insurance company and the person gets a life.”

• “I’ve never been able to understand how medical care providers will accept discounted payments from large insurance companies, but deny this same process to the patient off the street with no medical insurance,” wrote Maryann Root of Augusta, who started by saying she thinks everyone who receives medical care should have to pay something. “Everyone knows that hospital bills are inflated ridiculously, to allow for the discount. I say if hospitals were to adjust their billing reasonably, then they would have a greater expectation of being paid. Yes, even by indigent patients. ... So, if I were the hospital CEO, I’d exam Mr. Scott’s bill in detail. Did he really have use of all the supplies & equipment he was charged for, or was he charged for these items, just in case they’d be needed? And I’d review the hospital’s financial aid process. How can someone not make enough money to qualify? That makes no sense at all. By his letter, Mr. Scott appears to be a serious individual, not asking for a free ride, but just some help in paying his bill.”

• “I think I would probably have denied the assistance, for the simple reason of opening the floodgates of having other people want to receive the same treatment,” wrote Elena Hines of Kalamazoo. “However, the reason I am writing is to thank you for calling people’s attention that CEOs do have to make tough decisions … a fact that people often seem to forget.”

• “As a retired CFO (chief financial officer), I don’t find this problem that unusual or that difficult,” wrote Earl Lietzau of Paw Paw. “I would let the policy determine the result. The purpose of policies is to remove subjectivity from decisions and to try to ensure that multiple people come to the same conclusion given the same set of facts. If you deviate from the policy, you lose credibility and undermine the system. If I felt strongly that the policies were resulting in an inappropriate decision then I would work at changing the policies. This may or may not help Mr. Scott, depending how quickly the policies could be changed.”

• “What Mr. Scott did not say is if he had applied for Medicaid,” said a reader using the online screen name sportsman199. “If he is making as little as he said he is why is he not on Medicaid??? That is in place to help people pay for medical care. Why does the hospital have to write off everything and provide free care to someone who is not accepting help to pay his medical bills from the state of Michigan? I wonder if the person who told him he was making too little also referred him to the DHS to sign up for Medicaid. I get the feeling that there is more to this story.”

• “My question would be why is the cost so high to begin with” wrote a reader in an online posting, under the screen name Johntho. “$2,070 for a brief stay in an e-room is wondrous at best. Let me repeat, $2,070 is a rip-off price for any procedure or e-room visit. Someone please justify this cost. $100 for a mucus removal device, a Kleenex? $9 for an aspirin? Stop the insanity. Somebody please justify the cost of Medicare in the first place.”

Hospital spokeswoman Watts said that if Sardone has a comment to make on the situation, it would not be made until after in-house procedures are made.

Watts said that any time people incur a health care bill and are worried about how to pay, their first step should be to contact that health care provider or their insurer to inquire.

She said Bronson provided $74.6 million in uncompensated care and services to patients in 2008. She said statistics for 2009 will not be available until mid-year 2010.

According to the hospital’s community benefits report, the largest portion of that is what the hospital contributes in charity care and payment shortfalls from bad debt and Medicaid and Medicare. Those government programs pay only 36 cents and 40 cents, respectively, on the dollar, according to the report.

This opinion column was written by Al Jones. He can be reached at 269-388-8556 or ajones@kalamazoogazette.com.